Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 01560 | Date 06/10/2018 |
| Token No | SM/18-19/2824 12/10/2018 | Serial | 031 Last Visit: 12/10/2018 |
| Patient Name | Mrs. SARBANI CHAKRABORTY | Contact No | 7890592550 |
| Address | CHATRA BAGER BAGAN TELI PARA , BAIDYABATI(M) | Age | 40 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 160/100 mmHg | Weight | 49 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||